■胰腺癌(PC)是一种致命的疾病,尤其是转移性PC。它可以分为两种类型:头部胰腺癌(H-PC)和体尾胰腺癌(BT-PC)。先前的研究证明,它们具有不同的总体生存率(OS),应被视为PC的两个不同类别。目前,关于不同原发肿瘤位置和转移部位的OS,该领域仍然存在差距,以及与转移性PC患者的各种原发肿瘤位置相关的转移模式。因此,我们的研究旨在通过分析来自监测的大量人口的数据来解决这一差距,流行病学,和结束结果(SEER)数据库。不同原发肿瘤位置和转移部位的不同预后可能表明不同的原发位置和转移部位可能需要不同的治疗和随访策略。希望这些发现将为今后的指南更新和相关研究奠定基础。
■纳入了2010年至2015年间美国国家癌症研究所SEER计划的病理证实为IV期转移性PC的患者,排除各种肿瘤患者,不指定年龄,转移的特定部位,或操作系统。数据包括年龄,种族,性别,肿瘤大小,T级,N级,grade,网站,转移部位的数量,手术,放射治疗,从SEER数据库收集化疗和诊断年限.OS定义为从最初诊断到死亡日期的时期。比较了肿瘤不同原发位置的特定转移部位。通过Cox回归分析分析生存率。
■总的来说,14,406例转移性PC患者纳入本研究(7,104例H-PC和7,302例BT-PC)。性别比例,肿瘤大小,T级,N级,BT-PC和H-PC的原发灶手术和放疗转移部位数量不同。H-PC中只有1个转移部位的比例为68.3%,而BT-PC中为58.3%。与H-PC相比,BT-PC是肝转移的独立危险因素[比值比(OR)=1.510;95%置信区间(CI):1.320-1.727]。不管是那些有多发性转移的人,或者对于那些孤立的肝或肺转移瘤,转移性H-PC患者的OS较好(分别为P<0.001,P=0.001,P=0.04).在孤立性肝转移患者中,BT-PC的OS比H-PC更差[风险比(HR)=1.109;95%CI:1.046-1.175].
■转移性BT-PC的OS更差,罹患肝脏和多发性转移的风险增加。此外,在孤立性转移患者中,肝转移患者的生存率最差.
UNASSIGNED: Pancreatic cancer (PC) is a lethal disease, especially metastatic PC. And it can be divided into two types: head pancreatic cancer (H-PC) and body and tail pancreatic cancer (BT-PC). Prior studies have proved that they have different overall survival (OS) and should be regarded as two different categories of PC. At present, there remains a gap in the field regarding OS across different primary tumor locations and metastatic sites, as well as the metastatic patterns associated with various primary tumor locations in patients with metastatic PC. Thus, our study aims to address this gap by analyzing data from a large population sourced from the Surveillance, Epidemiology, and End Results (SEER) database. The different prognosis of different primary tumor locations and metastatic sites may indicate that different primary locations and metastatic sites may require different therapy and follow-up strategy. It is hoped that these findings will lay the groundwork for future guideline updates and related research.
UNASSIGNED: Patients with pathologically confirmed stage IV metastatic PC from the National Cancer Institute\'s SEER program between 2010 and 2015 were included, excluding patients with various tumors, without specifying age, specific sites of metastasis, or OS. Data including age, race, gender, tumor size, T stage, N stage, grade, sites, number of metastatic sites, surgery, radiotherapy, chemotherapy and years of diagnoses were collected from the SEER database. OS was defined as the period from initial diagnosis to the date of death. Specific metastatic sites for the different primary locations of tumor were compared. Survival was analyzed by Cox regression analyses.
UNASSIGNED: Overall, 14,406 patients with metastatic PC were included in this research (7,104 of H-PC and 7,302 of BT-PC). Gender proportion, tumor size, T stage, N stage, number of metastatic sites surgery of the primary lesions and radiotherapy were different between BT-PC and H-PC. The proportion of only 1 metastatic site was 68.3% in H-PC compared with 58.3% in the BT-PC. The BT-PC was an independent risk factor for liver metastases compared with the H-PC [odds ratio (OR) =1.510; 95% confidence interval (CI): 1.320-1.727]. No matter for those with multiple metastases, or for those with solitary liver or lung metastases, patients with metastatic H-PC showed better OS (P<0.001, P=0.001, P=0.04, respectively). In patients with solitary liver metastases, worse OS was observed in the BT-PC than the H-PC [hazard ratio (HR) =1.109; 95% CI: 1.046-1.175].
UNASSIGNED: The metastatic BT-PC had worse OS and increased risk to suffer from liver and multiple metastases. Moreover, in patients with solitary metastases, those with liver metastases presented poorest survival.